ENG APPROVED SEWER PERMITSEWER PERMIT
PERMIT NUMBER
City of Edmonds
www.cityofedmonds.gov
Description: Replace side sewer line from the house to the property line. ISSUED: 07/15/2021
Address: 22515 73RD PL W EDMONDS WA 98026-8305
EXPIRES: 10/15/2021
Permit Type: SEWER Permit Subtype: TOTAL LINE Parcel Number: 00391600300700
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT FISCHER PLUMBING 6608 220th St SW, Mountlake Terrace WA 98043 (206)783-4129
OWNER LEDGERWOOD ERIC & HEATHER 22515 73RD PL W, EDMONDS WA 98029
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00
ENGINEERING INSPECTION FEE $110.00 $110.00
SIDE SEWER PERMIT - FULL REPLACEMENT $110.00 $110.00
REQUIREMENTS
REQUIREMENT TYPE
NOTES
TRAFFIC CONTROL Traffic control and public safety shall be in accordance with City regulations as required by the City
Engineer. Every flagger must be trained as required by WAC 296-155-305 and must have certification
verifying completion of the required training in their posession.
RESTORATION Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with
asphalt or City approved material prior to the end of the workday - No Exceptions
WARRANTY The contractor is responsible for workmanship and materials for a period of one year following the final
inspection and acceptance of the work.
INSPECTION SCHEDULING: WWW.MYBUILDING PERMIT.COM
24 HR NOTICE REQUIRED
INDEMNITY
The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries, damages or claims of
any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or any of its departments
or employees, including but not limited to the defense of any legal proceedings including defense costs and attorney fees by reason of
granting this permit.
RELEAS
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
7/15/2021
DATE
Printed: Thursday, July 15, 2021 11:59:06 AM 1 of 2
SEWER PERMIT
City of Edmonds
www.cityofedmonds.gov• •
CONDITIONS
CONDITION TYPE
It is the owner's responsibility to repair/replace all damage of utilities or frontage improvements in
DAMAGE TO FRONTAGE
City right of Ways or Easements to City Standards caused by or occurring during the permitted
IMPROVEMENTS
project.
ESC REQ
Maintain erosion and sedimentation control per City and SWMMW standard requirements.
INSP PRIOR TO BACKFILL
Call for all required inspections. All work shall be inspected prior to backfill.
Owner/Contractor to provide Side Sewer asbuilt at final inspection. See City Handout E71 for
SEWER ASBUILT
requirements.
Sound/Noise originating from temporary construction sites as a result of construction activity are
exempt from the noise limits of ECC Chapter 5.30 only during the hours of 7:OOam to 6:OOpm on
SOUND OR NOISE
weekdays and 10:OOam and 6:OOpm on Saturdays, excluding Sundays and Federal Holidays. At all
other times the noise originating from construction sites/activities must comply with the noise limits
of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
All utilities shall be located prior to any excavation. New locates shall be called for if at time of
UTILITY LOCATES
excavation, original locates are no longer identifiable.
INSPECTIONS
INSPECTION TYPE
DATE
RESULT
COMPLETE
E-2 SEWER PRESSURE
E-2 SIDE SEWER
E-7 SEWER LATERAL
E-9 SEWER ASBUILT
X-2 ENGINEERING FINAL"
Printed: Thursday, July 15, 2021 11:59:06 AM 2 of 2
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CONTRACTOR INFORMATION:
SIDE SEWER
PERMIT APPLICATION
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Expiration Date: 7 / Z Z / �>L �—
PROPERTY INFORMATION: ,
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Owner's Name: /- r C, /- L d 07 0 K- W 0 H d
Phone #:
Site Contact:
Phone #:
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Email #: G D o
City Business License #
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❑ FULL LINE REPLACEMENT ❑ SPOT REPAIR PIPE BURST ❑ RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY THE SUBJECT PROPERTY OWNER.
CERTIFICATIONS NECESSARY FOR INSTALLATION METHODS ARE THE RESPONSIBILITY OF THE
CONTRACTOR PERFORMING SAID WORK.
I REPRESENT AND WAI
ADJACENT PROPER�Y,
PROPERTY.
SIGNATURE
TO VE CITY OF EDMONDS, IF REPAIR OF EXISTING SEWER EXTENDS TO AN
TOWERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
DATE
or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE